Important Update for Pharmacy Benefits Change: April 1, 2021

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Date: November 20, 2020
To: Health Plan of San Joaquin (HPSJ) Provider Network
From: Health Plan of San Joaquin
Subject: Important Update for Pharmacy Benefits Change:
• NEW – Effective Date moved to April 1, 2021
• State requests continued registration & preparation
Meanwhile: No change – HPSJ will continue to offer the pharmacy benefit until April 1, 2021
Business: Medi-Cal

Effective Date moved from January 1 to April 1, 2021

Per guidance (11/16/20) from the California Department of Health Care Services (DHCS)-

  • By April 1, 2021, Health Plan of San Joaquin pharmacy benefits will be transitioned to and administered by the agency Medi-Cal Rx.
  • ALL outpatient pharmacy drugs will then be covered by Medi-Cal Rx.
  • DHCS has partnered with Magellan Medicaid Administration, Inc. to provide this benefit and support Medi-Cal Rx.

With this extra time to prepare – (4) Things you can do NOW!
1. Register for the secure Medi-Cal Rx Provider Web Portal.

2. Create a plan for your HPSJ patients’ medication starting April 1, 2021. DHCS has
created a transition plan to ensure that coverage for beneficiaries’ medication will continue
from April 1, 2021.

3. Review online, www.Medi-CalRx.dhcs.ca.gov:

  • Medical Rx Pharmacy Transition Policy
  • Contract Drug List (CDL) and List of covered pharmacy providers

4. Call, if you have questions:

  • BEFORE APRIL 1, 2021: Medi-Cal Member Help Line, 1-800-541-5555 TTY/TDD 711, Monday through Friday, 8 am to 5 pm.
  • AS OF APRIL 1, 2021: Medi-Cal Rx Call Center Line, 1-800-977-2273 TTY/ TDD 711, 24/7, or visit www.Medi-CalRx.dhcs.ca.gov

During this transition, HPSJ wants to make sure our members are served without disruption – and you, your staff and business operations are supported. Look for more from HPSJ in coming days.

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